GP care retreat

The revelation in this newspaper that the Government is set to abandon a key election commitment to extend free GP care to almost 60,000 people with long-term illnesses puts a major dent in government health policy. It also raises serious questions about the ability of Minister for Health, James Reilly, to deliver free family doctor services for everyone in the lifetime of the current administration.

For a key policy first mooted in 2009 under the FairCare banner, when Fine Gael was in opposition, to be dogged by fundamental legal difficulties is an indication that the necessary groundwork in framing the policy was not carried out. And for it to take until half-way through the Government's term in office for the Attorney General's advice to precipitate the abandonment of a key plank in that policy suggests an extraordinary level of obduracy on the part of the Minister and a staggering inefficiency within the Department of Health.

As presently constituted, the Long Term Illness scheme is a rag-bag policy which benefits patients with certain illnesses while ignoring those with other chronic diseases (a person with epilepsy is eligible while someone suffering with asthma is not). Recipients gain free medications but must pay for GP services. But the scheme's inherent inequality has now been recognised by the Attorney General, who has reportedly described it as being legally frail.

Of greater and more fundamental concern however is the conclusion by the State's most senior law officer that granting medical cards on the basis of medical need rather than income could be open to legal challenge. This represents an effective death-knell for the current health policy of building up to the point where everyone in the State becomes entitled to free GP care.

There must also be a major doubt about the promised introduction of a more equitable model of universal health insurance (UHI). An honest declaration of the de facto situation by Taoiseach Enda Kenny and a fundamental reworking of health policy are now urgently needed.